PS02.232: BASALOID CARCINOMA OF THE ESOPHAGUS: MULTIMODAL APPROACH

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 188-188
Author(s):  
Marta De Vega ◽  
Carlos Miliani ◽  
Juan Rodriguez Vitoria ◽  
Juan Antonio Martinez-Piñeiro ◽  
Fernando Pereira
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Multimodal Treatment ◽  
Locally Advanced ◽  
Distal Esophagus ◽  
Lower Esophagus ◽  
Carcinoma Of The Esophagus ◽  
Basaloid Cell ◽  
Poorly Differentiated

Abstract Background Basaloid cell carcinoma of the esophagus (BSCCE) is a rare (0.07–4%) poorly-differentiated variety of squamous cell carcinoma (SCC), more aggressive and with a worse prognosis than typical SCC. There are no published studies on the best therapeutic option for these tumors or on of the effectiveness of Neoadjuvant chemoradiotherapie; so there is no standard treatment. We describe the characteristics and the therapeutic strategy applied to a patient with an avanced basaloid squamous cell carcinoma of the distal esophagus. Methods A 70-year-old woman with dysphagia and severe malnutrition was diagnosed with locally advanced esophageal cáncer of lower esophagus The biopsy indicated moderately differentiated basaloid cell carcinoma. The clinical diagnosis was cT4NxM0, We decided multimodal treatment with curative intent: Neoadjuvant chemoradiotherapie at a dose of 41.4 Gy and concomitant carboplatin and pacliotaxel 5 cycles (CROSS scheme) plus surgery. Results PET-TAC post-neoadjuvant re-evaluation showed partial morphological response (reduction of tumor metabolism in 34.7%). 6 weeks after radiochemotherapy we performed a three fields total esophagectomy. Postoperative course without incidents. The pathological diagnosis was BASALOID cell CARCINOMA located in distal esophagus of 10 cm long with 30% tumor residual; it affects gastro-oesophageal junction. Stage TNM 7th ed: ypT3 N0 (0/17) L0V1R0 Our patient is fine and without evidence of recurrence after 15 meses. Conclusion Basal squamous cell carcinoma is more common in men around 60 years old, being rare in older women. They are located more frequently in the middle than in lower esophagus. They are tumors of poor prognosis (poorly differentiated, locally advanced and with an aggressive biological behavior that predisposes to early metastasis) although the latest publications relate the prognosis especially with the stage of the tumor. There are no published data about the use of Neoadjuvant treatment for these tumors. We have carried out a multimodal treatment (Cross scheme) followed by surgery with clinical, radiological (PET-TAC) and pathological response (30% of residual tumor in the piece) CONCLUSION The multimodal treatment with Cross scheme and surgery was useful in patients with Basaloid tumor of the esophagus can be considered for patients with this type of tumor. Disclosure All authors have declared no conflicts of interest.

Role of chemoradiotherapy alone in the management of unfit patients with nonmetastatic locally advanced squamous cell carcinoma of the esophagus.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 138-138
Author(s):  
A. Pisa ◽  
I. Moya ◽  
C. Pericay ◽  
E. Dotor ◽  
J. Alfaro ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Surgical Procedures ◽  
Squamous Cell ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Advanced Squamous Cell Carcinoma ◽  
Carcinoma Of The Esophagus

138 Background: Surgery is considered the best treatment for patients (pts) with non-metastatic locally advanced squamous cell carcinoma of the esophagus who have responded to neoadjuvant chemoradiotherapy (CRT) in terms of locoregional control. However, in these pts PFS and OS have not been proved superior to those achieved by CRT alone. Besides, the addition of surgery to CRT increases treatment-related morbidity and mortality. Unfit pts are usually declined for surgical procedures and included in definitive CRT programs. The aim of this study was to define the role of non-surgical strategies (CRT, CT or RT) in unfit pts considered non-optimal for surgical procedures. Methods: We retrospectively reviewed 90 pts with squamous cell carcinoma of the esophagus who had been diagnosed and treated at our institution from January 2004 to December 2009. Fifty-one pts were non-metastatic among which 19 underwent surgery and 32 a non-surgical procedure (CRT, CT, RT or BSC). Our aim was to identify OS, PFS, RR, data on comorbidity and toxicity in these 32 pts. Results: Thirty out of the 32 pts were men with a median age of 62 years (range 41-90). Comorbidity was detected in 17 pts (53%) as means of respiratory disorders (21.9%), cardiopathy (12.5%), hepatopathy (21.9%), synchronic tumors (25%) and metachronic tumors (25%). Seventeen pts received CRT, 7 received CT, 1 received RT and 7 received BSC alone (53%, 22%, 3% and 22% respectively). Grade 3 and 4 toxicities were observed in 15 pts (46.9%) as means of mucositis (18.8%), oesophagitis (15.6%), diarrhoea (12.5%) and neutropaenia (12.5%). One patient in the CRT group died of toxicity. RR was 43.8% (70.6% for CRT, 14.3% for CT alone). Median follow-up was 17.2 months. Median PFS was 11.3 ± 6.12 months (17.9 for CRT, 5.1 for CT alone). Median OS was 15.6 ± 7.6 months (6.9 for CT alone). Conclusions: Our experience with CRT alone in unfit pts with locally advanced squamous cell carcinoma of the oesophagus supports its use with a median PFS of 17.9 months and controllable toxicity. Data on median OS are lacking due to pending long-term follow-up. No significant financial relationships to disclose.

scholarly journals Progression of Intravesical Condyloma Acuminata to Locally Advanced Poorly Differentiated Squamous Cell Carcinoma

2016 ◽  
Vol 7 ◽  
pp. 61-63
Author(s):  
A. Khambati ◽  
Y. Bhanji ◽  
D.T. Oberlin ◽  
X.J. Yang ◽  
R.B. Nadler ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Locally Advanced ◽  
Condyloma Acuminata ◽  
Poorly Differentiated

Definitive Chemoradiotherapy for T4 and/or M1 Lymph Node Squamous Cell Carcinoma of the Esophagus

1999 ◽  
Vol 17 (9) ◽  
pp. 2915-2915 ◽  
Author(s):  
Atsushi Ohtsu ◽  
Narikazu Boku ◽  
Kei Muro ◽  
Keisho Chin ◽  
Manabu Muto ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Locally Advanced ◽  
Dose Intensity ◽  
Complete Response ◽  
Carcinoma Of The Esophagus ◽  
Advanced Carcinoma ◽  
Grade 3

PURPOSE: To investigate the efficacy and feasibility of concurrent chemoradiotherapy for locally advanced carcinoma of the esophagus. PATIENTS AND METHODS: Fifty-four patients with clinically T4 and/or M1 lymph node (LYM) squamous cell carcinoma of the esophagus were enrolled. Patients received protracted infusion of fluorouracil 400 mg/m2/24 hours on days 1 to 5 and 8 to 12, 2-hour infusion of cisplatin 40 mg/m2 on days 1 and 8, and concurrent radiation therapy at a dose of 30 Gy in 15 fractions over 3 weeks. Filgrastim was prophylactically administered to 35 patients. This schedule was repeated twice every 5 weeks, for a total radiation dose of 60 Gy, followed by two courses of fluorouracil (800 mg/m2/24 hours for 5 days) and cisplatin (80 mg/m2 on day 1). RESULTS: There were 21 patients with T4M0 disease, one with T2M1 LYM, 17 with T3M1 LYM, and 15 withT4M1 LYM. Forty-nine patients (91%) completed at least the chemoradiotherapy segment. The 18 patients (33%) who achieved a complete response included nine (25%) of the 36 with T4 disease and nine (50%) of the 18 with non-T4 disease. Major toxicities were leukocytopenia and esophagitis; there were four (7%) treatment-related deaths. Prophylactic filgrastim reduced the incidence of grade 3 or worse leukopenia without improving dose-intensity or response. With a median follow-up duration of 43 months, median survival time was 9 months. The 3-year survival rate was 23%. CONCLUSION: Despite its significant toxicity, this combined modality seemed to have curative potential even in cases of locally advanced carcinoma of the esophagus.

Radio(chemo)therapy for locally advanced squamous cell carcinoma of the esophagus

2014 ◽  
Vol 191 (2) ◽  
pp. 153-160 ◽  
Author(s):  
Arif Deniz Ordu ◽  
Carsten Nieder ◽  
Hans Geinitz ◽  
Philipp Günther Kup ◽  
Lisa Felicia Deymann ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Locally Advanced ◽  
Advanced Squamous Cell Carcinoma ◽  
Carcinoma Of The Esophagus

scholarly journals A case of esophageal squamous cell carcinoma metastasized to the colonic anastomotic site of right hemicolectomy

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S64-S64
Author(s):  
Y Zhang ◽  
Y Nakanishi
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Right Hemicolectomy ◽  
Anastomotic Site ◽  
Carcinoma Of The Esophagus ◽  
History Of ◽  
Poorly Differentiated ◽  
Ileocolonic Anastomosis

Abstract Introduction/Objective Although squamous cell carcinoma of the esophagus rarely metastasizes to the uncommon sites, colonic metastasis from squamous cell carcinoma of the esophagus is extremely rare. There has been no case report of colonic metastasis from squamous cell carcinoma of the esophagus to an anastomotic site of the colon. Methods/Case Report A 73-year-old female with a history of right hemicolectomy for advanced ascending colon cancer in 2006 was referred to our facility for a two-month history of solid food dysphagia. The patient has been followed up in the survivorship clinic for surveillance with no evidence of recurrence for 13 years to date. An esophagogastroduodenoscopy revealed a 7 cm fungating and ulcerated mass in the middle to lower esophagus. The biopsy from the esophageal mass showed a moderately to poorly differentiated squamous cell carcinoma. A colonoscopy showed an end-to-end ileocolonic anastomosis with a 7 mm ulceration in the transverse colon. The biopsy from the ulceration at the anastomotic site showed a moderately to poorly differentiated squamous cell carcinoma. Immunostains performed on both esophageal and colonic biopsies demonstrate that the tumor cells in both esophageal and colonic biopsies are positive for p40, p63, p16, and negative for CK7, CK20, and CDX2. The diagnosis of metastatic esophageal squamous cell carcinoma to the colonic anastomotic site of previous right hemicolectomy was rendered based on the morphology and immunoprofile. A subsequent computed tomography (CT) and positron emission tomography (PET) demonstrated no other distant metastases. Chemotherapy with 5-FU and oxaliplatin has been started. A metastasis to the anastomotic site is extremely rare. Although the anastomotic site might be a good niche for cancer cells to metastasize to, the pathogenesis of a metastasis to the anastomotic site remains unknown. Our case is very intriguing because a metastasis occurred at the anastomosis site, and no other metastasis was found. Results (if a Case Study enter NA) N/A Conclusion We have reported the first case of metastatic esophageal squamous cell carcinoma to the colonic anastomotic site of previous right hemicolectomy in a 73-year-old female. Although the pathogenesis of a metastasis to the anastomotic site remains unknown, the possibility of contribution of surgical trauma to metastasis formation at the ileocolonic anastomosis cannot be completely ruled out.

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